Cardiomyopathy in Older Adults

Cardiomyopathy is a disorder of the myocardium, in which structural and functional abnormalities of the heart muscle result in mechanical and/or electrical cardiac dysfunction. Aging increases susceptibility to molecular damage and related risks of cardiomyopathy, often in combination with other chronic diseases and geriatric syndromes (e.g., frailty, sarcopenia). With the rapidly growing population of older adults, awareness of the most prevalent cardiomyopathies in this population provides important insight to optimize prevention and treatment.

Hypertrophic, restrictive and dilated cardiomyopathies are highly prevalent in older adults. Furthermore, coronary artery disease, hypertension and valve disease increase with aging, and often lead to myocardial abnormalities that have many similar features to cardiomyopathy that are important to clarify. This review provides important age-related perspectives regarding pathophysiology, diagnosis, management and prevention.

Aging is associated with inflammation and oxidative stress that can lead to molecular damage and vulnerability to many chronic diseases, including various cardiomyopathies. However, development is not inevitable. Prevention via lifestyle modification is paramount, with novel gerotherapeutic options targeting biologic hallmarks of aging under investigation. This increases the potential to improve the lifespan and healthspan of older adults.